Epidemiological Study Of COPD In Partial Area Of Shanghai And Recognition Of COPD Among General Practitioners

Chronic obstructive pulmonary disease (COPD) was one of the common diseases of respiratory system. Because of the high morbidity and mortality, it is at present the fourth cause of death around world and become a critical medical problem. In China, respiratory disease (mainly COPD) is the third cause of death in country side and fourth in cities. But unfortunately a large part of patients have no significant clinical manifestations in their early stage. Most patients are diagnosed moderate to severe stage when being diagnosed COPD and the treatment effect would not be ideal for these stages. The high morbidity, mortality of COPD as well as the burden of social economy have been a critical problem of public health. But at present people don’t take enough attention to this disease, especially the professional doctors of respiratory disease. It is a common problem that the cognition and attention are not enough as respect to COPD. The prevalence of spirometry is not adequate by now.This study surveyed the prevalence and risk factors of COPD and the cognition of this disease among general practitioners in4communities of2districts in Shanghai. There’re two parts in this study as followings:Part I:Epidemic situation and risk factors analysis of COPD in partial areas Of ShanghaiObjective:(1) To survey the Prevalence and relevant risk factors of chronic Obstructive Pulmonary disease (COPD) in partial areas of shanghai.(2) To provide a basis of the prevention and treatment for COPD.Methods:We targeted sampled4districts of Shanghai for study. By using cluster random sampling,12communities were chosen and1250respondents were enrolled into the study according to registered population older than40years of age. With the reference of the Burden of obstructive Lung Disease (BOLD) study, we designed a questionnaire for the respondents which was inquired by researchers. After physical examination, the respondents received examination for lung function and lung function indices (FEVI/FVC<70%) were regarded as gold criteria of diagnosis of COPD. The diagnosis of COPD was made according to the indices of FEV1/FVC, combining with history of respiratory tract disease.Results:(1)1252residents were surveyed and1211cases with complete data and qualified spirometry test were enrolled into the study. The total prevalence rate of COPD was8.6%.The prevalence of COPD in males was11.9%, and4.9%in females. The prevalence of COPD in males was significantly higher than that in females (χ2=19.08;P<0.001). By the multivariate logistic regression, it was found that the risk of COPD was increased with regard to smoking (OR=10.58,95%CI:6.79-16.50), family history (OR=43.74,95%CI:25.75～74.30), personal history (OR=21.04,95%CI:10.38～42.66), occupational exposure to dust (OR=391.23,95%CI:92.60～1652.92), bad ventilation condition of kitchen (OR=13.92,95%CI:8.38～23.12)Conclusions:The prevalence of COPD in partial areas of shanghai was8.6%. The prevalence of COPD in the males was11.9%, which was significantly higher than that in the female (4.9%). The risk factor of COPD included smoking, family history, respiratory infection in childhood, occupational exposure of dust, bad ventilation condition of kitchen. Part Ⅱ:Recognition of COPD among general practitioners in partial area of ShanghaiObjective:To survey the recognition of COPD among general practitioners in partial area of Shanghai. To improve the congnition of COPD among the doctors by short time of training.Methods:General practitioners from4communities were enrolled into the study. The doctors completed a knowledge form with respect to COPD before and after training and the results of score were compared.Results:(1) before training, the cognition of COPD among general practitioners was4.10±1.18, pass rate was11.5%. After training, cognition was7.90±0.90, pass rate was100%. The results demonstrated that age, education, career time, professional titles and type of work would affect the cognition of COPD among general practitioners.(2)the accuracy was comparatively low before training, which was lower than60%for every question. After training, the accuracy for every question was higher than60%. The deference of cognition of COPD before and after training was statistically significant (p<0.001).Conclusion:The cognition of COPD was low among general practitioners of partial area of Shanghai. After short time of training the cognition was improved effectively.